Children's Heart Institute
Subaortic stenosis refers to an obstruction or narrowing at the outlet of the left ventricle just below the aortic valve. In typical subaortic stenosis, the aortic valve itself is normal.
In the normal heart, there are two sides, and each side has a pumping chamber, called a "ventricle". The unoxygenated blood comes back from the body to the right side of the heart, where it collects in the right ventricle. The right ventricle pumps this blood through the pulmonary artery to the lungs, where it collects more oxygen.
The blood, now full of oxygen, returns to the left side of the heart and the left ventricle, where it is pumped through the left ventricle's outflow tract to the aortic valve and out to the body through the aorta. In a heart with subaortic stenosis, it is difficult for the left ventricle to pump the blood out to the body because of this narrowed area in the outflow tract.
Subaortic stenosis causes two main problems for the heart:
There are two kinds of subaortic stenosis:
The operation for discreet subaortic stenosis has a high likelihood of success. The operation begins with a vertical incision in the middle of the chest and dividing the breastbone. While repairing this area, it is necessary to work on a still, quiet heart, so use of the heart-lung bypass machine is required. The bypass machine will take the blood returning to the heart from the body and redirect it through a machine that will replace the oxygen in the blood. The blood is then returned to the body on the other side of the heart, allowing the heart to be still while it is repaired.
The subaortic stenosis is fixed by opening the aorta just above the aortic valve. The subaortic membrane can be seen through the valve. The membrane can then be cut out, leaving the left ventricle's outflow tract open and smooth. This operation is called a subaortic resection.
It is uncommon to have major complications after a subaortic resection. It is possible to have a leftover membrane, though it is extremely unusual for that to cause any remaining obstruction. Other very uncommon complications include damage to the aortic valve itself, heart block, which is a problem with the electrical conduction of the heart, or creating a hole between the two pumping chambers (ventricular septal defect). Most patients who undergo a subaortic resection are able to be discharged with 3-4 days after surgery.
Pediatric Cardiology ClinicUniversity of Texas Health Science Center Professional Building
6410 Fannin, Suite 500
Houston, TX 77030
Phone: (832) 325-6516
Pediatric Cardiovascular Surgery ClinicUniversity of Texas Health Science Center Professional Building6410 Fannin, Suite 950Houston, TX 77030
Phone: (713) 500-7339
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